Cost of crown lengthening

Contents

Crown Lengthening for a Prettier Smile

“If the gum line is uneven, crown lengthening can also sculpt the gum line to produce a more symmetrical smile,” says Dr. Harms. Crown lengthening may be done for dental care and medical reasons as well as for the cosmetic effect. If there’s decay or fracture under the gum line, for example, crown lengthening can help expose more of the tooth’s crown in order to support a filling or porcelain crown.

What Does Crown Lengthening Involve?

Crown lengthening involves oral surgery performed under local anesthesia. After the area is numbed, the dentist or periodontist makes small cuts to pull the gums away from the teeth and remove excess gum. In some cases, removing gum tissue is all that is needed to expose more of the crown. But if there is too much soft tissue and bone covering the crown, a tiny bit of bone may need to be taken out, too. After the surgery is completed, the gums are washed with sterile salt water and stitched up.

Pros and Cons of Crown Lengthening

Although crown lengthening is a common and safe procedure, it does involve surgery, which always has risks. So it’s important to weigh the pros and cons before going under the knife.

Advantages of crown lengthening: Unlike many cosmetic dentistry treatments, crown lengthening only needs to be done once, with no requirement for touch-ups down the road. In addition to creating a wider, more symmetrical smile, crown lengthening can provide some dental care benefits as well. “It can reduce the risk of tooth decay because more of the tooth is exposed for brushing and flossing,” says Harms. The surgery can usually be completed in 30 minutes to an hour.

Disadvantages of crown lengthening: This cosmetic dentistry treatment can be pricey. Expect to pay $1,000 to $4,000 for crown lengthening. If the procedure is medically warranted, insurance should pick up some of cost, says Harms. As with other types of cosmetic surgery, you may experience swelling and pain afterwards. Recovery can take a few days to a few weeks, depending on how extensive the surgery is. Possible complications include excessive bleeding and infection, but these are rare.

Recovery From a Crown Lengthening Procedure

Following surgery, you’ll be given a prescription for a pain reliever and instructed to use ice to reduce any swelling. You’ll want to eat a diet of fairly soft foods and brush your teeth carefully in the area near the stitches, which will come out in 7 to 10 days.

Complete healing of the gums can take up to three months, however. At that point, you may opt to have veneers or another cosmetic dentistry procedure done, such as bonding or tooth whitening.

Is Crown Lengthening Right For You?

If you’ve always been bothered by a smile that shows too much gum, crown lengthening may be worth the cost and the short-term discomfort. But, for people who have wide teeth, crown lengthening could backfire. “You could end up with teeth that look too big,” says Harms. (Some dental practices offer computer imaging, which will show you what the final result will look like.) On the other hand, if you are especially susceptible to tooth decay, crown lengthening can make it easier for you to take proper care of your teeth and perhaps decrease your risk of decay.

If you have excessive or uneven gums, crown lengthening can transform your smile and give you just the right look — and as an added bonus, it may just improve your overall dental health as well.

By Parsa T. Zadeh, DDS, FAGD

Article in PDF format: Gum Lift – What to Expect

What is the “Gummy Smile Surgery” or Gum Lift?

The term “Gum Lift” was coined by Dr. Zadeh in 1989 to describe the surgical procedure which is often performed to reduce the “gummy smile’ that some individuals have.

It is performed as an out patient procedure at the Beverly Hills Center for Reconstructive and Cosmetic Dentistry.

The technical description for “Gum Lift” is “Crown Lengthening thru an apically positioned muco-periosteal flap and osseous recontouring”. In simple language, The existing gum is separated from the underlying bone, the excess bone is trimmed and the same gum tissue is placed back and stitched at a higher level but we just like to call it the gummy smile surgery. The result is a biologically stable and acceptable proportion of bone and gum which are now less visible.

Is Gummy Smile Surgery Just Cutting Off of the Excess Gum Tissue?

No. This procedure is different from the simple “cutting off” (gingivectomy) of the excess gum that can be achieved by a: Laser, b: Radio-surgery or c: Surgical knife. The “cutting off” of the gum edge, while having some useful indications, is very limited in what it can achieve. When the very limited biological restrictions are violated, the gum will either re-grow or a permanent state of gingivitis will develop. For a stable and permanent improvement the underlying bone must be also reduced proportionately.

Is the Gummy Smile Procedure Painful?

The actual procedure that takes about 2 to 3 hours to complete is done under local anesthesia, the same way most other dental procedures are done. While local anesthesia is sufficient to perform the Gum Lift completely painlessly, Dr. Zadeh has found that most patients do better and are more comfortable when some degree of sedation is used. You can discuss the suitable technique of sedation for your case with Dr. Zadeh.

Gum Lift is a minor surgery and there will be a wound that carries the same discomforts, limitations and delicacies of any other wound in the body. Post-operatively, you will be given two types of pain medications that you can use as you see fit.

However, interestingly, most patients report a degree of “numbness” on the gum at the operated site rather than “pain”. Apparently, the nerve fibers that are supposed to carry the pain signals from the gums are cut-off and there is “no sensation” from the gum! Most of the discomfort of the procedure comes from the swelling of the area rather than the wound itself.

Here is another example of Michael and his gummy smile surgery before and after photos:

How Long is the Recovery After Your Gummy Smile Surgery?

For fastest and most comfortable recovery, Dr. Zadeh’s recommendations are as follows:

For the day of the procedure: Bed rest. Do not plan on ANY activity after you leave the office. If you have had any type of sedation, you must arrange for a ride home/to your hotel. You must arrange for the medications and few days of suitable food in advance of the procedure.

For days 2 and 3: You must minimize your physical activity. This is a great time to catch up with books, internet and TV. If you have traveled from out of town, it is better if you do not travel back until the 4th day. Physical activity during this period increases the post operative swelling which is the primary cause of post-operative discomfort.

Days 4 thru 9: You can resume all normal activity from the 4th day on except work outs.

10th day on: No special consideration for the procedure needed.

How Many Visits Does It Take?

The procedure is done in one visit. Dr. Zadeh would like to see the patient one more time in the days following the procedure to make sure the tissues are holding up well. For out of town patients, the pre-operative work up can be done through photographs and telephone conversations.

Will there be Stitches?

Yes. If you are local, the remaining stitches are removed after 6 days. If you are traveling, resorbable stitches are used that do not require professional removal.

What are the Possible Complications from the Gummy Smile Surgery?

Basically NONE. If patients follow the instructions in taking the prescribed antibiotics, resting and proper dieting following the procedure, there is nothing that can go “wrong”.

Dr. Zadeh has performed close to a thousand of these procedures and has had no complication so far. However, there can be some consequences to this procedure that the patient must be aware of:

-Some teeth sensitivity will occur that usually disappears few months later.

-The gum numbness that was earlier mentioned can take up to a year to completely go away.

-“Spaces” between the teeth take 10 to 14 months to fill up by gum if gums are kept healthy during this period.

Will I later need Veneers or Crowns on my Teeth?

It depends. This is a very important question that must be discussed BEFORE the procedure is done with Dr. Zadeh.

Whether you would need further restorative work on your teeth after the gum lift or not, depends on the preexisting condition of your teeth and gums and how much gum lift you want done.

-Dr. Zadeh can walk you through the published pictures of his cases at the web site so that you can see how much gum lift you need and can expect from gum lift without any further work on the teeth. Many of the more drastic improvements have been accomplished by a combination of gum lift and restorative procedures.

– In many cases a gum lift is all that is needed to give you a perfect smile:

– In some other cases a gum lift can improve your smile but a more desirable result can be achieved if it is followed by some restorative procedures:

You must discuss this including all the expenses of it with Dr. Zadeh before the procedure because the gum lift procedure VARIES in technique depending on whether a restorative procedure is going to follow or not.

Are there Any Guarantees?

Yes. Dr. Zadeh guarantees that the final results will be similar to the preoperative computer imaging of your case. Of course natural tissues heal and move differently from computer images and exact replication is not possible. Slight asymmetries can happen due to differences in root prominences of the teeth. After complete healing, if necessary, Dr. Zadeh will trim the gum edges (as part of the main procedure) to correct these irregularities.

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What Is Gum Contouring and Reshaping Longview, TX

What is gum contouring?
This is cosmetic procedure that is used to change the shape of your gums. A Longview dentist can use this procedure to cut away excessive gum tissue that is giving you a “gummy” smile or to restore gum tissue that has receded and is now exposing too much of your teeth.

How do I know if I need gum contouring?
Typically, this is a highly personal decision that is made based on how you feel about your gums. If your gums are uneven, or they cover too much or too little of your teeth, then you may be a good candidate for gum contouring or gum reshaping. To find out, call 1-903-757-6243 and schedule an appointment with our Longview, TX dental office.

Is there pain associated with the procedure?
There can be, but you will be medicated during the procedure, which will reduce the likelihood of you feeling any pain during it. How much really depends on how much gum tissue is being cut away, shaped, or grafted. Additionally, the type of dental tools used will impact what your gums feel like afterward. Currently, 75605 dentists are using both scalpels and lasers to complete gum procedures.

What is the recovery time like?
This also heavily depends on the type of tools used to complete the procedure. When a scalpel is used for gum contouring, sutures will be necessary and there will be more overall irritation. Very often, lasers can treat the gums without cutting or sutures, decreasing the recovery time. Regardless, you will experience some swelling and discomfort afterward. You can manage it by applying ice packs to your face for 15 minutes at a time and using ibuprofen.

Check out what others are saying about our gum contouring services on Yelp: What Is Gum Contouring and Reshaping Longview.

Are there any restrictions during recovery?
Yes. You will need to be careful with what you eat. Since your gums will be sensitive, you should avoid eating anything that is sharp or that could cut, poke, or irritate them in any way. For this reason, most people stick with a soft diet of yogurt, soup, ice cream, pudding, etc. for a couple of days. If your gum reshaping was performed using a scalpel, it is likely that you will be scheduled for a follow-up visit. At that point, your Longview dentist will examine the gums to determine if everything is healing properly, and if it is, they will let you know when you can return to all your normal dietary habits. Additionally, you may be prescribed an antibiotic rinse to use in order to combat a potential infection, and when you do brush your teeth, you will need to do so very gently.

Is gum shaping different from gum contouring?
These terms are used interchangeably by 75605 dentists who perform them. Some may use contouring to describe the procedure with the use of a scalpel and reshaping when lasers are used. At the end of the day, the approach and objective are very similar. It is the tools that are different. The key is that if you want your gums to look different, it doesn’t really matter which term is used, both contouring and reshaping can be an excellent solution.

Is this purely a cosmetic procedure, or is there a medical reasons for contouring and shaping?
That depends on why you want to schedule a gum reshaping. If you are calling our office because you suffer from gum disease, we will first examine you to determine if you have the condition, discuss your treatment options, and work to eliminate the actual disease. At that point, you may very well need a gum contouring procedure in order to restore gums that have receded and are now putting the health of your teeth, roots, and jawbone at risk. In a very real sense, gum contouring and grafting can help save your teeth.

While typically gum recession is caused by gum disease, you could also experience this due to excessive tooth brushing, taking a prescription drug, or even genetics. In this case, as with gum disease, restoring your gum tissue may become necessary for your optimum oral health.

Crown lengthening surgery – How Much Is a Crown Lengthening Procedure – Orthodontist In Houston, TX

Furthermore, if your gum line is not even, crown lengthening surgery can be used to sculpt it so that a more symmetrical look can be achieved. This dental procedure can be carried out for medical, dental and cosmetic reasons.

In a situation whereby there is a fracture or decay below your gum line, crown lengthening surgery can help in exposing more of the crown of your teeth. This will go a long way in ensuring that a porcelain crown or filling is supported.

What Does Crown Lengthening Involve?

Gum removal surgery is usually carried out with the aid of a local anesthesia. As soon as the anesthesia is applied, your dentist will make small incisions that will ensure that gums are pulled away from your teeth. This will go a long way in removing excess gum that makes your smile to be horrible.

In some instances, your gum tissue will be removed so that more of your crown will be exposed. If the soft tissue as well as bone covering your crown are too much, a bone removal will be inevitable. On completion of the surgery, your gums will be washed with germ-free salt water and the treatment area will be stitched up.

Cost of Crown Lengthening

There are many factors that determine crown lengthening cost. Some of them include your location, number of teeth involved, experience of the dentist and so on. Ideally, you should be prepared to spend between $1000 and $4000 for the procedure. If it is medically warranted, your insurance may cover part of the cost.

Pros and Cons of Crown Lengthening

There are many advantages and disadvantages associated with crown lengthening. It is very essential for you to consider them before taking a decision on the procedure.

Advantages of crown lengthening

Contrary to many procedures in cosmetic dentistry, crown lengthening is carried out once without the need for touch-ups. Apart for making your teeth to be more symmetrical, it can also reduce your exposure to tooth decay because your teeth will be more exposed for brushing as well as flossing. Furthermore, it doesn’t take so much time as it can be completed between 30 minutes and one hour.

Disadvantages of crown lengthening

It is a bit pricey but can be partly covered by insurance if medically warranted. You should expect swelling and crown lengthening pain, just like every other surgery. Healing can take time, usually some days to weeks, and this is dependent on the extensiveness of the surgery. Some of the side effects of the procedure include infection and excessive bleeding but they are rarely experienced.

Recovery From a Crown Lengthening Procedure

After your surgery, your dentist will give you a pain reliever that will ease your pain. You will also be asked to apply a pack of ice to the treatment area so that swelling will be reduced. You should eat soft foods during your recovery period and brushing should be done with care.

Within 7 to 10 days, your stitches should be able to come off. Typically, your gums will totally heal up within 3 months. Afterwards, you can go for other cosmetic procedures like veneers, tooth whitening or bonding.

Is Crown Lengthening Right For You?

In order to know your eligibility for crown lengthening, you should visit Edge Dental Houston. In most cases, if your smile is revealing too much gum, you may need to go for the procedure.

FAQs about Crown lengthening surgery

When is dental crown lengthening necessary?

In a situation whereby you are experiencing tooth fractures or decay that gets down to your bone level, you may need a crown lengthening. You will be further guided at Edge Dental Houston.

How to treat pain on your gum line?

In-office treatments are available at Edge Dental Houston to fix this type of problem. Periodontal therapy may be recommended to further stop gum erosion. Grafting and crown lengthening are other treatment options available.

What is a better option between crown lengthening and implant?

Since the two procedures are not the same, your condition will determine the best option for you. You should see your dentist for necessary guidance.

How much should crown lengthening on 8 teeth cost?

Before this question can be properly answered, a lot of things need to be considered. The location of the teeth, lengthening technique to be used, experience of the dentist and so on.

How long should you wait to smoke weed after a dental implant?

Smoking should be totally avoided after your dental implant if you don’t want it to fail. You should try as much as possible to stay away from smoking after your implant. Afterall, you will not want your investment to go down the drains.

Why are dental crowns recommended after a root canal?

Your dentist may recommend dental crowns after a root canal in order to prevent costly, future dental treatments. It also prevents infections from cropping up due to bacterial activities.

Can you reverse receding gum lines?

There are in-office treatments available for receding gum lines. Periodontal therapy may be recommended and there are surgical procedures that can fix the problem.

What can I do about my receding gums?

When you have receding gums, the best thing for you to do is to see your dentist. Your dentist is in the best position to recommend treatment options for you.

How much does a tooth crowning cost in Delhi?

The experience of your dentist, the type of crown to be used and the number of teeth to be crowned will determine your final cost.

How can periodontitis be cured?

Periodontitis may not be permanently cured. Your oral hygiene plays a major role in controlling bacteria colonization of your mouth which can lead to the disease.

Conclusion

For the best crown lengthening surgery, Edge Dental Houston is perfect clinic to visit. You can’t get it better elsewhere, especially in today’s world.

Gingivectomy

The gum tissue, or gingiva, can be very thick and redundant, extending over the crown and covering the tooth surface, making the teeth look short. There are several causes of this excess gum tissue including medications, the bone that extends too close to the surface of the teeth, inflammation due to gum disease, or altered passive eruption.

A gingivectomy is a periodontal procedure that eliminates excess gum tissue. The term “gingivectomy” is derived from the Latin word “gingiva” which means gum tissue and the suffix “-ectomy” which means to remove.

Dr. Noraian may perform a gingivectomy for the following reasons:

  • Cosmetics: To restore normal appearance in the size of the teeth when the gum is covering too much of its surface. A gingivectomy will make the teeth appear longer and more proportional.
  • Functional/Esthetics: To remove overgrown gum tissue that has formed as a result of taking of certain drugs such as anti-seizure, anti-hypertensive and organ-transplant medications.
  • Bone and gum health around the teeth: A gingivectomy reduces deep gum pockets when the bone is not involved, which improves the bone and gum health around the teeth.

About the Procedure

While anesthetized, Dr. Noraian will remove the excess gum tissue with a scalpel blade or a laser depending on tissue thickness. In most cases, you will not require sutures (stitches). The surgical sites will be tender for 24-48 hours, and Dr. Noraian will provide medication to alleviate any discomfort you may experience. You will probably see Dr. Noraian for a follow-up appointment after two weeks so he can ensure you are healing properly.

Get the smile you’ve always wanted!

For more information about Gingivectomy or to schedule a consultation with Dr. Noraian, please call our Bloomington IL office at Bloomington IL Office Phone Number 309-663-4577 or

Book an Appointment Today

Gingival Sculpting – Reshaping Gum Tissue

Gingival sculpting, also known as gingival contouring, is the process of reshaping the gum tissue around your teeth.

A cosmetic dental treatment that can help reinvent your smile and improve your oral health, gingival sculpting involves a minimally invasive laser procedure to remove and re-sculpt uneven or excessive gum tissue. Typically, however, soft tissue sculpting also requires bone recontouring that cannot be accomplished with a laser alone. The result is healthy and natural-looking gums for a vital, young-looking and attractive smile that adds to your confidence and appeal.

Sculpting procedures can be performed for cosmetic reasons, as well as for oral health reasons such as poor dental hygiene. The latter can result in the formation of deep gum pockets due to improper tooth brushing and the accumulation of calculus and plaque. Common aesthetic problems that can be corrected include gummy smile (excessive gingival display), uneven (asymmetrical) gingival contours, the loss of papillae (small amounts of gum tissue between your teeth) and exposed root surfaces.

It also can help address aesthetic concerns of teeth that appear “too small” or are unusually shaped. This may result when the surrounding gum tissue has grown down and over a large portion of the teeth, creating the illusion of small or crooked/oddly angled teeth. The gum contouring process removes and re-shapes the extra gum tissue to lift the gum line and reveal more teeth and/or even out the gum line for enhanced symmetry. This procedure removes extra gum tissue without leaving a deficit and only exposes the part of the tooth that is normally visible.

What’s Involved?

Gingival sculpting is most commonly performed by periodontists and cosmetic dentists.

The minor in-office gum contouring procedure typically requires only one visit of about an hour. After a local anesthetic is applied to the gums, a soft tissue laser is used to trim away, re-contour and seal the excess gum tissue. There is only minor discomfort and no bleeding or stitches are involved.

More commonly, the procedure to reduce tissue and bone requires more time and stitches, yet it creates no pain.

Consultation and Treatment Planning

The fine points of your consultation and subsequent treatment planning depends on the condition of your gums and your sculpting objectives.

For example, during a regular checkup, your dentist may notice that the tissues surrounding your teeth are receding or excessive. If this is the case, your consultation may include a discussion of gingival tissue regeneration in order to prevent, correct or stop periodontal disease. Your dentist may suggest multiple treatment options, such as flap surgery, bone grafts, tissue grafts, gingival colored composite build-up or tissue stimulation.

If you are planning a cosmetic dental procedure such as veneers or a smile makeover, your dentist may advise you that the appearance of your gum line is uneven, or that you have too much gum tissue (gummy smile). If gum tissue reduction is necessary, your dentist may discuss laser treatments to remove the excess gum tissue — which require little-to-no healing time — or more invasive surgical options.

As part of your treatment planning, your dentist also will advise you of the healing times for the procedure you will undergo, as well as whether local anesthesia or sedation dentistry is necessary.

Keep in mind, however, that some procedures — such as those involved with correcting minor unevenness of your gum line — may be completed without a formal consultation or treatment plan. Today’s dental laser technology makes it possible for your dentist to discuss and treat such conditions as gingival asymmetry and gummy smiles during regular visits and/or cleaning appointments. Because every case is different, other situations may require more detailed discussion, planning and consultation.

Recovery and Post-procedure Care

In general, it is not uncommon to experience minor swelling and discomfort after the procedure. The specific type of procedure you undergo will affect your healing time, as well as the level of discomfort you experience during your recovery.

Typically, gingival sculpting procedures require no more than one day for healing; however, your dentist may advise you to follow a strict diet of soft foods or liquids for a few days. If your procedure involves grafts or bone contouring, it will likely involve stitches and your dentist also may limit physical activity to prevent reopening of the surgical site. To relieve pain and, if necessary, prevent infection, your dentist may prescribe medications to be taken as directed.

Benefits

Gingival sculpting or crown lengthening is safe, fast and virtually painless. You can continue your normal activities right after treatment, and the results are permanent.

The laser gingival sculpting procedure — which seals and sterilizes the treatment area — significantly reduces your chance of infection, minimizes inflammation and promotes fast healing. Lasers also provide greater precision, protecting the surrounding tissue from damage during the procedure.

Gingival sculpting can have psychological and social benefits, improving your looks and self-confidence, encouraging you to be more socially active and making you more willing to smile. You feel happier and seem friendlier and more approachable.

Risks

Gum sculpting is considered surgery, so it is important for your periodontist or dentist to fully inform you about any possible risks associated with the procedure before you undergo treatment. However, since gingival sculpting is typically performed under only local anesthesia, there’s little to fear of the risks associated with general anesthesia.

While extremely rare, you may experience infection at the treatment site, or some minor swelling and discomfort after surgery.

Check the credentials of the periodontist or general dentist performing the procedure to ensure that he or she is properly trained and skilled in oral surgery and the use of dental lasers, and has considerable experience and practice in performing gingival sculpting.

Costs

Dental insurance companies typically do not cover gum sculpting, which is considered a cosmetic procedure. Procedure costs vary by dentist and the extent of the procedure (e.g., number of teeth involved, how much excess gum must be removed). For example, a gingivectomy or gingivoplasty involving one to three contiguous teeth costs on average about $235, while the same procedures that involve four or more contiguous teeth costs on average approximately $425. Clinical crown lengthening procedures cost approximately $550.

(Read more about dental insurance coverage)

Therefore, it is important to inquire at your dental office about specific costs and financing options.

Do not dismiss the oral health costs, either. Apart from its purely aesthetic aspects, gingival sculpting also has health benefits. For instance, removing excess gum tissue can reduce deep gum pockets, which can harbor harmful bacteria that can contribute to infection and gum disease in the form of gingivitis or periodontitis. These forms of gum disease have been further linked to heart disease, diabetes and respiratory problems.

It also can positively impact your mental health, boosting your self-image and social confidence by improving your appearance. Additionally, the use of laser surgery to perform gingival sculpting involves less risk of infection, promotes faster healing and offers greater surgical precision to protect surrounding tissue from damage. All of these factors should be considered when determining if treatment makes sense for you.

5 Common Reasons For Gum Surgery

Sometimes, in spite of making your best attempt to take good care of your gums and teeth, problems arise that require specialized dental procedures. Once your gums become infected or damaged, they should to be treated with a cosmetic dentistry Houston provides such as an oral surgeon. Fortunately, there a number of modern procedures that can be used to treat problems with your gums. Without treatment, the problem will get worse and soon lead to problems with your teeth, mouth and jawbone. Gum surgery is primarily done to help reinstate the health of your gums. Some of the most common reasons for gum surgery include removing excess gums for more tooth exposure and reshaping the gums.

Gingivectomy and Gingivoplasty

A gingivectomy is when the gingiva or gum tissue is surgically removed. Gingivoplasty is when the gum tissue around your teeth is surgically reshaped.

What is a Gingivectomy Used for?

Originally, a gingivectomy was used as a treatment for periodontal disease; however, today it frequently used as a cosmetic procedure. You may require cosmetic dentistry in Houston for a gingivectomy if pockets or gaps have formed between the teeth and gums. The pockets trap particles of food, which promotes the growth of bacteria that can cause further damage to the gums and teeth. A gingivectomy is also used to remove excess gum tissue from around your teeth. The excess gum may make it difficult to thoroughly clean between your teeth as well as interfere with your speech and/or eating.

What is Gingivoplasty Used for?

Gingivoplasty is often used to reshape your gums, which will make the gums look more natural. This procedure is also used to correct badly formed gums, asymmetrical gums, trauma to the gums or for cosmetic purposes.

Gingival Flap Surgery

A gingival flap procedure is done by separating the teeth from the gums, in order for the dentist to temporarily fold back the gum tissue in order to reach the bone and root of the tooth. This procedure is used to treat periodontitis (gum disease). Gingival flap surgery is usually recommended for those with moderate to advanced periodontitis. Typically before a gingival flap procedure is done, the dentist will often try a procedure known as scaling and root planing. If the gum infection is not removed during the scaling and root planing, gingival flap surgery may be required in order to remove all of the infection.

Gum Contouring

Gum reshaping is also known as crown lengthening and/or gum contouring, is a cosmetic dental procedure used to improve the look of your teeth. This procedure is often done when patients have a “gummy smile”; a condition in which the gums cover too much of the teeth, making the teeth look too short. A gummy smile can interfere with a persons’ desire to smile. When gum contouring is done for cosmetic reasons, it typically has a positive impact on the persons’ self-confidence.

Soft Tissue Graft

When tooth roots are exposed due to gums that are receding, gum graft surgery is used to repair the defective gum, which is beneficial for preventing additional recession as well as the risk of bone loss. A gum graft can be used to cover the roots of a tooth or as a way to develop gum tissue when there is excessive absence of the gum. During this procedure, the oral surgeon will remove gum tissue from your palate or from another donor source and use the gum tissue to cover the exposed root. Soft tissue grafts can be done for one or more teeth to reduce sensitivity and to even the gum line.

Although gum surgery is used for a number of reasons, the most common reason is due to gum disease. It is extremely important to get in the habit of practicing good oral hygiene, which includes brushing twice each day and flossing at least once a day. It is also important to schedule routine visits with your dentist for cleanings and checkups. The sooner the dentist discovers damages on the gums, the easier the treatment may be.

As a necessary part in keeping your teeth healthy, take a moment and contact us to schedule an appointment today.

Crown Lengthening

This Common Surgical Procedure Restores Function and Improves Appearance

A Consultation with Dr. Steven W. Seibert

Dear Doctor,
As a senior citizen, I was surprised to get a cavity. What’s more, my dentist says that before it can be filled, I will need a procedure called “crown lengthening.” Can you explain what that is?

Dear John,
Some people think tooth decay affects only the chewing surfaces of the teeth, and is mostly found in children. However, cavities can occur on all vulnerable tooth surfaces, and may be a problem for people at any age; in fact, some studies show that seniors have a higher rate of tooth decay than children. And because of gum recession, older people may develop cavities at or just below the gum line, which are sometimes harder to treat.

When the upper teeth appear too short, a “gummy smile” can be corrected by periodontal plastic surgery to remove excess tissue and lengthen teeth.

After periodontal crown lengthening establishes a more aesthetic tooth length, porcelain veneers can help create a beautiful smile.

Dentistry by Dr. Elizabeth M. Bakeman

If you have a cavity below the gum line, it can’t be filled in the usual way because gum tissue is covering the area that needs to be treated. In such cases, a minor surgical procedure called “crown lengthening” may be necessary. The crown is the visible part of the tooth—so as the name suggests, crown lengthening exposes more of the tooth’s surface, giving the dentist more tooth structure to work with.

When decay reaches under the gum line, a crown lengthening procedure can reposition the gum tissue further away from the biting surface of the tooth, so the cavity can be filled. It can also be used to treat other dental conditions—for example, to restore a tooth that is broken near the gum line or place a crown or bridge on teeth that have too little healthy tooth structure remaining. A prosthetic crown (sometimes called a cap) will not attach properly if there is not enough tooth surface to hold onto. An ill-fitting crown may damage gum tissue, resulting in eventual bone loss, or permit decay to occur under the crown, leading to more significant dental problems.

In addition to dental restorations, crown lengthening is popular in cosmetic dentistry. This procedure—sometimes called a “gum lift”—can improve aesthetics for people who feel that their teeth are too short, or that too much gum tissue shows when they smile. Having an uneven gum line can also make even straight teeth appear irregular. By changing the visible gum-to-tooth ratio and gum contour, crown lengthening can greatly improve a “gummy” smile, make teeth appear longer and straighter, and improve symmetry. Adjusting the gum line for a better smile is not always a purely cosmetic endeavor: When there is too much gum tissue, an individual can be more susceptible to gum infections.

Crown lengthening is performed by some general dentists, but is more commonly referred to periodontists: dentists who specialize in treatment of the gums and other supporting structures of the teeth. The procedure is typically done in a dental office using the kind of local anesthesia you might get for a normal tooth filling, sometimes in combination with a sedative medication.

After anesthesia, your dentist begins the procedure by making small incisions in the gum, which allows a tiny “flap” of tissue to be lifted out of the way. The underlying bone tissue is reshaped to properly support the gum tissue in its improved position. The flap of tissue is then repositioned and sutured into place, following the contours of the gum line. This exposes sufficient tooth surface to reestablish the proper size of the teeth for an appealing and very natural look.

Crown lengthening, like all types of minor surgery, has accompanying risks such as bleeding and infection. Your dentist will give you post-operative instructions to minimize these risks. For the first few days after the procedure, your dentist may advise you to stick to soft food, avoid vigorous physical activity and use an ice pack when needed. You may need a prescription or over-the-counter pain reliever, and you may be prescribed an antibiotic to reduce the chance of infection. The initial soreness you may experience will decrease in a few days.

If tooth restoration is necessary, it will not happen on the same day as crown lengthening. First, the gums will be allowed to heal for 6-12 weeks. This helps ensure that the gums are in their final position so the tooth restoration will look natural.

The crown lengthening procedure is considered irreversible, since it usually involves removing some bone. For this reason, it is important to consider and discuss all current and future treatment options.

Whether it’s done for functional reasons (to help restore your oral health), or aesthetic reasons (to improve appearance), crown lengthening can save a tooth—or even save your smile. If you are wondering whether it could be right for you, ask your general dentist or periodontist.

Improving a ‘Gummy Smile’ Depends on its Cause

A “gummy” smile, in which the upper gums are too prominent, is a common condition. There are several causes for gummy smiles — determining which one is the first step to having your appearance changed.

Although perceptions vary from person to person, most dentists agree a gummy smile shows 4 mm or more of gum tissue, and the amount is out of proportion with the length of the crown (the visible tooth). Teeth normally erupt through the gums during childhood and continue development until early adulthood, shrinking back from the tooth until stabilizing in place.

This typically produces a crown length of about 10 mm, with a “width to length” ratio of about 75-85%. But variations can produce differences in the relationship between teeth and gums and the width to length ratio of the teeth. The teeth may appear shorter and the gums more prominent. Worn teeth, caused by aging or grinding habits, may also appear shorter.

If tooth to gum proportionality is normal, then the cause may be upper lip movement. When we smile, muscles cause our lips to retract 6-8 mm from the lip’s resting position. If the amount of movement is greater (meaning the lip is hypermobile), it may show too much of the gums. The upper jaw can also extend too far forward and cause the gums to appear too prominent.

There are a number of ways to improve gummy smiles, depending on the cause. Periodontal plastic surgery known as crown lengthening removes and reshapes excess gum tissue to reveal more of the tooth. Lip hypermobility can be reduced with Botox injections (to paralyze the muscles) or in some cases with surgery to reposition the muscle attachments. Orthognathic surgery can be used to surgically reposition an overextended upper jaw. Other cosmetic enhancements such as orthodontics, bonding or porcelain restorations can also prove effective.

The first step is to obtain an accurate diagnosis for your gummy smile. From there, we can devise the best treatment approach to bring your smile back into a more attractive proportion.

If you would like more information on minimizing a gummy smile, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Gummy Smiles.”

Dental Health Topics

This dental procedure code is somewhat unique in that it covers more than one specific procedure.
While both a gingivectomy and gingivoplasty involve the surgical excision of gum tissue, a gingivectomy is done to remove diseased gum tissue surrounding a gum pocket.
A gingivoplasty is performed to reshape gum tissue – sometimes after a gingivectomy, but most often independent of a gingivectomy.
Both procedures can also be performed solely for cosmetic reasons, but when done so are not covered under this code. When these two procedures are covered it is because of a clinical cause, periodontal disease.
Periodontal disease affects the gums and the bone to which a tooth is attached. It is an advanced bacterial infection that causes tooth loss and gum recession, and is preceded by gingivitis.
Symptoms can include bleeding from the gums, bone loss that displays itself on an x-ray, excessive tooth mobility, gum recession, or the existence of any exudate (pus or clear fluid) along or under, the gumline.
As periodontal disease progresses, the visible markers of the disease (plaque and calculus) migrate down along the side of the tooth into the natural pocket between the ridge of the gumline and the tooth’s enamel. In doing so, it inflames the gum tissue and widens the naturally slim gap between the tooth and gum.
As this gap becomes wider, even more bacteria are allowed access to the sensitive tissue fibers along the root’s outer surface, and much damage can be done.
In order to arrest the progression of the disease, a gingivectomy is often prescribed. Likewise, a gingivoplasty which can re-shape the gumline, can be used to combat disease in oddly shaped or overgrown gums.
The procedures for this dental procedure code are fairly straightforward despite their surgical nature.
In both procedures, your dentist will first thoroughly clean your teeth to ensure the area is free of plaque and calculus from the area (likely, periodontal scaling and root planing), and then administer a local anesthetic to numb the area.
Then, with a gingivoplasty, your dentist will shape and remove any portion of gum tissue that contributes to disease. Gingivoplasty incisions only take a few minutes, and are done with an eye toward aesthetics.
With a gingivectomy, after the area is numb, your dentist will use a probe to determine the depth of the pocket so as to understand where to make the incision.
The idea is to remove enough gum tissue to eliminate the pocket, and no more. Therefore, once this depth is determined, the gum tissue is cut at a 45 degree angle to the tooth, with the downward slope of the angle aiming toward the tooth’s root.
Since this can be difficult to envision, consider the following example:
The cut the dentist makes in this procedure is the same sort of cut you would make if you were wanting to remove a portion of the wood from a pencil to get to a stubby graphite tip. So, if your tooth were the stubby tip that you didn’t want to cut off, the cut you would make would slope downward toward the eraser in the pencil example, and in the gingivectomy example, downward toward the root.
Dentists refer to this cut as apical.
Your dentist will only remove as much tissue as is necessary – remember, tooth pockets are measured in millimeters, not inches.
While most gingivectomies are usually performed with a scalpel, they can also be performed using electrosurgery units, diamond burrs, and lasers.
Once the procedure is complete, a surgical dressing would be placed on the gum tissue that has been cut, and you will be given instructions as to how you should care for your mouth in the days following the procedure.
To look up and find more CDT dental codes from the American Dental Association, please visit our complete Dental Procedure Code Library.

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